Benefits Verification Specialist

CVS Health

1d•Onsite

About The Position

CVS Health is building a world of health around every individual, shaping a more connected, convenient, and compassionate health experience. Colleagues are passionate, innovative, accountable, and prioritize safety and quality. This role is part of a larger mission to simplify health care one person, one family, and one community at a time. Candidates must live within a commutable distance (within 60 minutes) to Malvern, PA; Mendota Heights, MN; or San Diego, CA. The shift is Monday-Friday, 8:30am - 5pm CST or 9am - 5:30pm CST. Coram/CVS Health is seeking a high-energy healthcare professional to join their National team as a Benefit Verification Specialist. This position involves working closely with Patient Intake Coordinators and insurance providers to verify coverage for in-home Specialty therapies for Coram's patients. Benefit Verification Specialists are crucial for creating a positive patient experience. In this dynamic and fast-paced role, the specialist will verify insurance coverage and obtain prior authorization information for new and existing patients to process prescription orders promptly, while providing excellent customer service to patients, healthcare professionals, and insurance carriers. The role requires an understanding of insurance carriers and concepts including pharmacy benefits, major medical benefits, per diem coverage, and knowledge of government and patient assistance programs.

Requirements

Experience verifying benefits with insurance companies
Data entry experience
Working knowledge in Microsoft Office, specifically Outlook and Word
Verifiable High School diploma or GED is required

Nice To Haves

Home infusion or durable medical equipment (DME) experience
Experience work in a healthcare environment
Experience working with healthcare insurance

Responsibilities

Complete and document benefit verification review
Provides information on specialty medications/ home infusion services
Comply with and adhere to all regulatory compliance areas, policies, and procedures, and "best practices."
Coordinate with the Patient Intake Coordinators for new and existing accounts
Investigate type and level of insurance coverage to assess patient eligibility for the program
Communicate with medical professionals and insurance company personnel
Complete data enter in ACIS to ensure accuracy of reporting and outcomes
Provide input on self reviews
Assist less experienced peers
Perform other duties & responsibilities that are reasonable as assigned by your leaders

Benefits

Comprehensive and competitive mix of pay and benefits
Comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources, based on eligibility
CVS Health bonus, commission or short-term incentive program